Complications after treatment of femoral neck fracture with single-headed and double-headed cannulated screws

Abstract

Objective To compare complications after of treatment of femoral neck fracture with single-headed and double-headed cannulated screws.Methods The 126 patients who had been admitted for femoral neck fracture from April 2001 to June 2009 were prospectively assigned to treatment with either single-headed or double-headed cannulated screw fixation following closed reduction according to the odd or even number of their admission date.In the single-headed group,there were 65 patients,41 males and 24 females (mean age,61.5 ±:3.2 years),29 cases of Garden types Ⅰ and Ⅱ and 36 cases of Garden types of Ⅲ and Ⅳ.In the double-headed group,there were 61 patients,35 males and 26 females (mean age,59.6 ± 2.6 years),24 cases of Garden types of Ⅰ and Ⅱ and 37 cases of Garden types of Ⅲ and Ⅳ.The two groups were compared in terms of nonunion,avascular necrosis of thefemoral head,screw backing-out,and the axis length of femoral head and neck after fracture union.Results The 126 patients were followed up for 3 to 11 years (mean,79 months).The single-headed group had a higher rate of nonunion [15.4％ (10/65) versus 3.3％ (2/61)],a higher rate of screw backing-out [16.9％ (11/65) versus 1.6％ (1/61)],a shorter axis length of femoral head and neck (7.00±0.36 cm versus 8.33±0.24 cm) than the double-headed group.All the above differences were statistically significant between the 2 groups (P ＜ 0.05).There was no significant difference between the 2 groups in femoral head avascular necrosis [16.9％ (11/65) versus 13.1％ (8/61)] (P ＞ 0.05).Conclusion Compared with single-headed cannulated screws,double-headed cannulated screws can reduce nonunion rate and screw backing-out,and maximally retain the axis length of femoral head and neck in the treatment of femoral neck fracture,but cannot reduce incidence of avascular necrosis of the femoral head. Key words: Femoral neck fractures; Fracture fixation, internal; Bone nails; Postoperative complications